Neurological hand exercise

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Neurological hand exercise
Typing can be a beneficial hand exercise after a stroke. (Jupiterimages/Photos.com/Getty Images)

So much human activity depends on using your hands with their unique opposable thumbs. When a neurological condition affects hand function, your daily activities can come to a crashing halt. Depending on the condition and the severity, simple tasks like buttoning shirts, grasping a fork, picking up a glass or dialing a phone are difficult or impossible. For some neurological diseases, like multiple sclerosis, hand exercises aren't effective in regaining function. For other disorders, however, hand exercises can be rehabilitative.

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Identification

Hand function can be affected by Parkinson's disease, carpal tunnel syndrome, dystonia, Guillain-Barre syndrome, multiple sclerosis, spinal cord injury and stroke. In Parkinson's disease, parts of the brain that control body movement are damaged. Carpal tunnel syndrome is caused by inflammation and constriction of the median nerve as it travels through a narrow channel in the wrist. Dystonia is characterized by involuntary muscle movements that cause muscles to “compete” for body part control because there’s a malfunction in the usual muscle relaxation process. The body's own immune system attacks nerves in Guillain-Barre syndrome. In multiple sclerosis the immune system destroys the myelin sheath surrounding nerves.

Significance

Exercise rehabilitation is most effective if you’ve suffered a stroke or are a carpal tunnel syndrome patient. In other neurological diseases, physical therapy is used as an adjunct to drug therapy to address the underlying neurological problem. Physiotherapy may help reduce tremors and teach techniques to brace or assist your affected body parts. Exercises are devised on a one-on-one basis between you and your physiotherapist.

Carpal tunnel exercises

Exercises for carpal tunnel syndrome involve stretching and lengthening the tendons that pass through the carpal tunnel and exert pressure on your median nerve. Strengthening related muscles, which support the wrist and hand, also help hand health. Stretching exercises include the wrist extensor and wrist flexor stretch. To stretch the wrist extensor, extend your arm in front of you with the back of your hand up. Bend your hand down at the wrist and, using your other hand gently put a little pressure on your extended hand. Hold for 10 to 20 seconds. Repeat twice two or three times a day.

Strengthening exercises are isometric ones in which muscles contract against resistance but without movement as well as concentric ones that involve holding weights and movement. Isometric exercises should be done first. An example of an isometric exercise is to make a fist of your injured hand and bend it upward, resisting this movement by placing your other hand on top of the knuckles. Hold for five to 10 seconds and repeat five to 10 times. Exercising should not cause pain. If pain persists, consult your GP.

Stroke exercise features

When part of your brain is damaged by a stroke, you’ll need to relearn how to do things. Physiotherapists help by using sensory stimulation to the affected hand, range-of-motion exercises, such as curling and uncurling each finger, and by temporarily restraining the healthy hand to encourage use of your afflicted hand.

Expert insight

Post-ischemic hand exercises also may be useful after a stroke. These include picking up pens, manipulating balls and moving fingers independently of one another. Such exercises are effective say Johannes Smits and Else Smits-Boone, authors of "Hand Recovery After Stroke." Smits devised a regimen of such exercises after he experienced a stroke. He continued his exercises for two years before switching to a maintenance schedule, at which point he had regained 85 percent of function. For maintenance, Smits continued with hand exercises, like throwing a ball back and forth between hands. He added this to walking, riding an exercise bike and routine daily tasks.

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